Most of this site is about slowing down and thinking carefully. This article is the opposite.
If your dog has a swollen, hard abdomen and is retching repeatedly without bringing anything up, stop reading and drive to a vet. Call them from the car.
Everything else here is for reading beforehand, which is the only time it is any use.
What is happening
The stomach fills with gas and distends. In gastric dilatation-volvulus, it then rotates on itself, sealing both ends so nothing can escape.
The consequences cascade fast:
- The distended stomach presses on major blood vessels, so blood cannot return to the heart
- Blood supply to the stomach wall and spleen is cut off, and tissue begins to die
- The dog goes into shock
- Toxins release as tissue dies
This kills healthy dogs within hours. It is one of the very few conditions in dogs where the difference between going now and going in the morning is reliably the difference between a dog you keep and one you do not.
The signs
- A visibly swollen, hard, drum-tight abdomen, usually most obvious behind the ribs on the left side
- Repeated retching that produces nothing, or only a little foam or saliva. This is the single most characteristic sign
- Heavy drooling
- Pacing, restlessness, unable to lie down or settle in any position
- Obvious distress and anxiety
- Standing with elbows out, neck extended
- As it progresses: pale gums, rapid shallow breathing, weakness, collapse
The swelling is not always dramatic, particularly in deep-chested dogs where the chest hides it. Do not wait for a visibly bloated abdomen if the retching pattern is there.
What to do
Drive. Now.
Call from the car so the clinic can prepare. This is a condition where minutes of preparation matter, and a practice that knows you are coming can have fluids and theatre ready.
Do not:
- Attempt to make your dog vomit
- Give anything by mouth, food, water, medication, home remedies
- Try to relieve the gas yourself
- Wait to see whether it settles
- Spend time looking for a better clinic than the nearest one
There is no useful home treatment for bloat. Every minute spent trying something is a minute of tissue dying.
What the vet will do
Stabilisation first, intravenous fluids for shock, pain relief, and decompression of the stomach to release the gas pressure. Then imaging to confirm whether the stomach has twisted.
If it has twisted, it is surgical, and urgently so. The surgeon untwists the stomach, assesses whether any tissue has died, and usually performs a gastropexy, tacking the stomach to the body wall so it cannot rotate again.
It is expensive, and the conversation will happen fast and under pressure. Knowing that in advance is part of what this article is for.
Who is at risk
Deep-chested breeds, with risk rising with size and age:
Great Danes, German Shepherds, Dobermans, Weimaraners, Standard Poodles, Boxers, Setters, Saint Bernards, Bloodhounds. Large indies with deep chests are not exempt.
Other associated factors: eating one large meal daily, eating very fast, and a first-degree relative that has had it. Raised feeding bowls have been associated with increased risk in some studies, which is worth knowing given how often they are recommended for large dogs.
Reducing the risk
Feed two or three smaller meals rather than one large one.
Slow fast eaters, a slow-feeder bowl, a puzzle feeder, or scattering food.
Avoid vigorous exercise immediately before and after meals. An hour either side is the usual advice.
Consider preventive gastropexy if you have a high-risk breed. The stomach is tacked to the body wall surgically, commonly at the time of neutering, and it substantially reduces the risk of a twist. For a Great Dane or a large deep-chested dog, this is a genuinely worthwhile conversation to have with your vet before anything happens rather than after.
Know your nearest emergency clinic, its hours, and the route. Save the number now.
The bottom line
Swollen, hard belly. Retching that produces nothing. Drooling. Pacing and unable to settle.
That is bloat until proven otherwise, and it is one of the very few things in dog ownership where the correct response is to stop thinking and start driving.
If you own a deep-chested breed, learn those four signs, feed smaller meals, and ask your vet about a preventive gastropexy while your dog is well.
Retching and vomiting in a comfortable dog with a soft abdomen is a different and far less urgent problem. It is the distension and the unproductive retching together that make this one.